| Blue Fox Wellness Llc | |
|
4600 Montgomery Blvd Ne Ste B203 Albuquerque NM 87109-1202 | |
| (505) 421-0814 | |
| Not Available |
| Full Name | Blue Fox Wellness Llc |
|---|---|
| Speciality | Counselor |
| Location | 4600 Montgomery Blvd Ne Ste B203, Albuquerque, New Mexico |
| Authorized Official Name and Position | Dierdre Wilson (OWNER) |
| Authorized Official Contact | 5054210814 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Fox Wellness Llc 4600 Montgomery Blvd Ne Ste B203 Albuquerque NM 87109-1202 Ph: (505) 421-0814 | Blue Fox Wellness Llc 4600 Montgomery Blvd Ne Ste B203 Albuquerque NM 87109-1202 Ph: (505) 421-0814 |
| NPI Number | 1437740511 |
|---|---|
| Provider Enumeration Date | 02/01/2021 |
| Last Update Date | 11/02/2022 |
| Certification Date | 11/02/2022 |
| Medicare PECOS PAC ID | 8022539188 |
|---|---|
| Medicare Enrollment ID | O20250305001334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437740511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Dierdre Wilson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568773190 PECOS PAC ID: 5395266456 Enrollment ID: I20250305001548 |
| Provider Name | Stephanie Turner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821596792 PECOS PAC ID: 8729509849 Enrollment ID: I20250305003048 |
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